Nutritional Advice El Mondo

Nutritional advice

Sport nutrition

Scientific studies (review articles) on the relationship between diet/nutrients and sport performance:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2021:

  1. Chair-based exercise programmes improve upper extremity and lower extremity function in older adults
  2. Supplementation with L‐arginine alone increases VO2 max in healthy people
  3. Whey protein supplementation increases lean body mass in adults
  4. Protein quality has significant impact on indices of muscle protein anabolism in young and older adults
  5. Tart cherry supplementation improves recovery from strenuous exercise
  6. Physical activity enhances immune system and increases potency of vaccination
  7. 3 times per week 30-60 min high-intensity interval training causally reduce visceral adipose tissue

2020:

  1. High-load and low-load resistance training have similar effects on femoral neck and lumbar spine bone mineral density
  2. 10-12 g/d arginine during 8 weeks improve sport performance
  3. Physical exercise offers benefits to patients with chronic kidney disease
  4. 30 min/day light-intensity physical activity reduce cancer mortality
  5. Protein supplementation increases lean body mass in adults
  6. Whole-body vibration improves bone mineral density in postmenopausal women

2019:

  1. Strength training decreases inflammation in adults
  2. Creatine supplementation does not induce renal damage
  3. Exercise intervention in kidney transplant recipients improves quality of life
  4. 3 mg creatine/kg/day for 14 days improve anaerobic performance in soccer players
  5. Physical activity reduces lung cancer among smokers

2018:

  1. 1-6g/d taurine supplementation improves human endurance performance
  2. 10,000 steps a day do not decrease blood pressure in healthy adults
  3. Milk protein supplements + resistance training increase fat-free mass in older adults
  4. Aerobic exercise benefits global cognition in mild cognitive impairment patients

2017:

  1. Every 500 kcal increase per week reduce Alzheimer’s disease with 13%
  2. No more than 1.62 g/kg/day dietary protein supplementation augments resistance exercise training induced gains in muscle mass and strength in healthy adults
  3. High levels of physical activity reduce risk of breast cancer in postmenopausal women with a BMI until 30
  4. Resistance training reduces blood pressure in prehypertensive and hypertensive subjects
  5. It is probably better to consume a low-glycemic-index carbohydrate meal before endurance performance
  6. 688mg polyphenol supplementation for at least 7 days increases sport performance
  7. Decreased walking pace increases risk of dementia in elderly populations
  8. Creatine supplementation is effective in upper limb strength performance for exercise of maximum 3 minutes

2016:

  1. Aerobic exercise performed in the fasted state induces higher fat oxidation than exercise performed in the fed state

2014:

  1. Exercise lowers the risk for diabetes conferred by insulin resistance
  2. Exercise training helps to prevent and to treat type 2 diabetes in youth
  3. Recreational physical activity reduces risk of gastric cancer

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Athletes who have a healthy, balanced diet, do not need vitamin and/or mineral supplements. Vitamin and mineral supplements cannot directly enhance sports performance. However, they can shorten the recovery period between training sessions and therefore, enhancing indirectly sports performance.

When you still want to take dietary supplements, it is good to know that:

  • The positive effect of the supplement is dependent on the dosage and duration.
  • The bioavailability is never 100%. For example, the bioavailability of L-carnitine supplement is 15-20%, meaning when 300 mg of L-carnitine supplement is taken, the body can only absorbed 45-60 mg.
  • Dietary supplements are not always free of doping.
  • The supplement only works when a positive conclusion was found in a review of randomized placebo-controlled, double-blind clinical trials (RCTs).
  • Do not take supplements during physical exercises because they can adversely affect the sports performance.

It has been scientifically proven that water, carbohydrates, creatine and caffeine intake during physical exercises can increase sports performance.

A diet with less than 55 En% carbohydrates and/or less than 20 En% fat has negative effects on the sports performance.

It can take 2-3 days to restore the muscle glycogen level after physical exercises when a low-carbohydrate diet (<5 grams of carbohydrate per kg body weight) was taken.

The loading phase of carbohydrates and creatine:  
During physical exercises athletes get mainly energy from carbohydrates, stored in the body as glycogen. Creatine is also an important energy supplier during physical exercises, which need a lot of energy in a very short time. Therefore, it is recommendable to increase the glycogen and creatine body stores just prior to a competition.

The loading phase of glycogen consists of reducing the training frequency while increasing the carbohydrate intake, 3 days before a competition. The carbohydrate intake during these 3 days is 7-10 grams per kg body weight per day.

Increasing muscle creatine stores can be done in 2 phases: the loading and maintenance phase. The 2 ways to increase muscle creatine stores are:

  1. 0.3 grams of creatine per kg body weight per day (5-7 grams of creatine each time with an interval of 3-4 hours) and 3-7 days long. After that, 3-5 grams of creatine per day for 4-10 weeks.
  2. 2-3 grams of creatine a day for 30 days.

The glycogen resynthesis (to restore the glycogen body stores after physical exercises) takes quickly place within 30-60 minutes after physical exercises. The speed of the glycogen resynthesis reaches its maximum at 0.8 grams of carbohydrate per kg body weight per hour.

The muscle and bone building phase take place during 24-48 hours after physical exercises.

It is a misconception to think isotonic sports drink is absorbed faster than hypotonic sports drink.

Rehydration drinks should have an osmolality of below 500 mOsm/l, preferably below 300 and a sugar content of 40-80 grams per liter. Rehydration is the replenishment of moisture during physical exercises.

Isotonic sports drink has an osmolality of about 300 mOsm/l and a sugar content of 40-80 grams per liter. During physical exercises, isotonic sports drink is recommended and hypertonic sports drinks (>80 grams of sugar per liter) must be avoided. The osmolality of human blood is approximately 275-300 mOsm/l.

Sports drinks with 40-80 grams of carbohydrates and 280-660 mg of sodium per liter are quickly absorbed in the body. This is the ideal isotonic sports drink. Sports drink is recommended in moderate physical exercises with a duration longer than 60-90 minutes.

It is internationally recommended to take 250 ml of liquid (or 1000 ml of fluid per hour) per 15 minutes during the competition in order to prevent dehydration, but also to maintain the sports performance. Furthermore, it is a scientific fact that the body can break down maximum 60 grams of carbohydrates per hour during the competition.

When you are feeling energetic during physical exercises, meaning that you have taken enough carbohydrates.

The best period to eat is 2-4 hours before physical exercises.

The common nutritional deficiencies among athletes are a deficiency of calcium, vitamin D and iron (especially under women athletes).

Dietary guidelines for athletes:

  • The last meal should be 2-4 hours before physical exercises.
  • Professional athletes are advised to choose products with 60-70 En% (minimum 55 En%) carbohydrate, products with 20-30 En% fat and products with 15-25 En% protein or your daily diet (=all meals/products that you eat on a daily basis) should on average contain 60-70 En% (minimum 55 En%) carbohydrate, products with 20-30 En% fat and products with 15-25 En% protein.
  • Take dietary supplements only under expert guidance!
  • 0.5 mg of vitamin B1 per 1000 kcal.
  • 0.6 mg of vitamin B2 per 1000 kcal.
  • 0.02 milligrams of vitamin B6 per gram of protein consumed.
  • The recommended daily allowance is 6 mg of magnesium per kg body weight.
  • The recommended daily allowance is 5-7 grams of carbohydrates per kg body weight per day.
  • The recommended daily allowance of protein for athletes is 1.2-1.8 grams per kg body weight, for strength athletes is 1.5 grams per kilogram of body weight during the maintenance phase and 2.0 g per kg body weight during the loading phase.

Before physical exercises:

  • Take 2 hours before the competition 500-1000 ml of fluid.
  • Take 5 to 30 minutes before the competition 50 grams of sugars.
  • Take 10 grams of protein just before the competition because it promotes the recovery of muscle damage.
  • Take 3-5 minutes before the competition 150-300 ml of water or thirst quencher. This is called prehydration.

During physical exercises:

  • Take during the competition no more than 35 grams of fructose per liter because fructose is slowly absorbed and therefore will give gastrointestinal complaints.
  • Take during the competition 125-250 ml of fluid per 15 minutes.
  • Take during the competition no more than 15 grams of sugars per 15 minutes.
  • The optimal sports drink during the competition is a sports drink with 6 g sugars per 100 ml.
  • Choose a sports drink during the competition with an osmolality around 300 or below 500 mOsm/l.
  • Avoid during the competition hypertonic sports drinks.
  • Take during the competition water, isotonic or hypotonic sports drinks.
  • Take during the competition no coffee because you will lose more moisture.

After physical exercises:

  • After the competition, there are 2 ways to restore the glycogen body stores:
    1. Take immediately (within 30 minutes) after the competition 1.2 grams carbohydrate (preferably simple sugars, such as glucose) per kg body weight. Repeat this every hour for 4-6 hours.
    2. 0.8 g carbohydrate per kg body weight + 0.4 grams of protein or amino acids per kg body weight per hour. Repeat this every hour for 4-6 hours.
  • It is advisable to take after the competition 1.5 times the amount of water lost during the competition.
  • Take 10 grams of protein within 30 minutes after the competition because it promotes the recovery of muscle damage.

Diabetes

Scientific studies (review articles) on the relationship between diet/nutrients and diabetes prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2022:

  1. 500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension
  2. Vitamin D deficiency increases blindness in people with diabetes
  3. 50 g/d almond decreases causally bad cholesterol in patients with type 2 diabetes
  4. Ginger supplementation reduces blood pressure in patients with type 2 diabetes

2021:

  1. Higher concentrations of carotenoids reduce type 2 diabetes
  2. Dietary sodium restriction causally reduces blood pressure in patients with type 2 diabetes mellitus
  3. Daily 80g potato increase type 2 diabetes among Western populations
  4. Vitamin C supplements improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus
  5. Spirulina supplementation reduces bad cholesterol among type 2 diabetes patients
  6. Grapes/grape products supplementation reduces HOMA-IR values in adults
  7. Intensive glucose control slows down cognitive decline in persons with type 2 diabetes
  8. Chromium supplementation improves lipid profile in patients with type 2 diabetes mellitus
  9. Patients with diabetes mellitus should be vaccinated against herpes zoster
  10. L-arginine supplements do not reduce diabetes in adults
  11. 1.5 g/day garlic supplementation reduces adiponectin level among participants ˂30 years
  12. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  13. Peanut butter consumption may reduce type 2 diabetes
  14. Patients older than 60 years, with hypertension, diabetes and D-dimer values above 3.17 µg/mL have higher thrombotic events due to COVID-19
  15. Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults
  16. 1.5 g/day EPA + DHA improve insulin sensitivity in children
  17. Oral vitamin C supplementation may improve glycemic control and blood pressure in people with type 2 diabetes
  18. Type 1 diabetes mellitus decreases bone mineral density in children and adolescents

2020:

  1. BCG vaccine should not be used in treatment of type 1 diabetes mellitus
  2. 2-3 servings/week fish reduce all-cause mortality in patients with type 2 diabetes
  3. Most prevalent comorbidities among COVID-19 are hypertension, diabetes, cardiovascular disease, liver disease, lung disease, malignancy, cerebrovascular disease, COPD and asthma
  4. Vitamin B3 supplementation increases good cholesterol in patients with type 2 diabetes mellitus
  5. Patients with diabetes should be advised to continue taking metformin drugs despite COVID-19 infection status
  6. Daily 8.4-10 grams of inulin supplements for at least 8 weeks improve risk factors of type 2 diabetes
  7. Male, age, cardiovascular disease, hypertension and diabetes mellitus increase mortality in patients with COVID-19
  8. Diabetes mellitus is associated with severe infection and mortality in patients with COVID-19
  9. Barberry supplementation improves insulin levels
  10. Diabetes increases in-hospital mortality in patients with COVID-19
  11. Daily 40g soy consumption for <12 weeks increase IGF-1 level
  12. 100 mg/day magnesium dietary intake reduce type 2 diabetes
  13. 50g/day processed meat increase type 2 diabetes
  14. Yogurt intake is associated with a reduced risk of type 2 diabetes
  15. Hypertension, diabetes, COPD, cardiovascular disease and cerebrovascular disease are major risk factors for patients with COVID-19
  16. Hypertension, cardiovascular diseases, diabetes mellitus, smoking, COPD, malignancy and chronic kidney disease are risk factors for COVID-19 infection
  17. Omega-3 fatty acids + vitamin E or D reduce gestational diabetes
  18. Psyllium consumption improves risk factors of diabetes
  19. Soy protein dietary intake reduces type 2 diabetes

2019:

  1. Elevated serum/plasma zinc concentration increases risk of type 2 diabetes
  2. 100mg magnesium dietary intake reduce type 2 diabetes
  3. Consumption of tree nuts decreases HOMA-IR and fasting insulin levels
  4. Low-fat dairy products have a beneficial effect on HOMA-IR, waist circumference and body weight
  5. Whole grain and cereal fiber dietary intake reduce type 2 diabetes
  6. Dietary low-ratio n-6/n-3 PUFA supplementation improves insulin resistance in diabetic patients
  7. Zinc supplementation reduces diabetes mellitus
  8. Moderate plant protein decreases type 2 diabetes mellitus
  9. Probiotic and synbiotic supplementation reduce inflammation in diabetic patients
  10. Folate supplementation lowers HOMA-IR
  11. 13.1 g/day viscous fiber supplements improve glycemic control

2018:

  1. 1 serving/day potato increases risk type 2 diabetes
  2. 150 g/day French-fries consumption increases risk of hypertension
  3. Garlic increases good cholesterol in diabetic patients
  4. High intake of cereal fiber may reduce type 2 diabetes
  5. Ginger intake reduces body weight and fasting glucose among overweight and obese subjects
  6. Animal protein increases risk of type 2 diabetes
  7. ≥550 mg/day flavonoids intake reduce type 2 diabetes
  8. High-fat diets increase risk of type 2 diabetes
  9. Folic acid supplementation reduces both fasting glucose level, fasting insulin level and HOMA-IR
  10. Low-GI diet is good for patients with type 2 diabetes
  11. Vitamin K supplementation has no effect on glycemic control
  12. Daily 3 mg L-carnitine during 12 weeks reduce serum leptin concentrations in diabetic patients

2017:

  1. Each 1 mmol/L increase in serum potassium reduces type 2 diabetes mellitus by 17%
  2. Fish oil supplementation during <12 weeks improves insulin sensitivity among people with metabolic disorders
  3. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  4. Pomegranate supplementation has no favourable effect on improvements in glucose and insulin metabolism
  5. Low carbohydrate diet decreases type 2 diabetes
  6. A diet with 4.4 g/day alpha-linolenic acid during 3 months does not reduce level of HbA1c, FBG or FBI in patients with type 2 diabetes
  7. Vegetarian diet has a protective effect against diabetes risk
  8. Weekly 30-180 gram chocolate consumption reduces risk of coronary heart disease, stroke and diabetes
  9. Probiotics supplementation improves HbA1c and fasting insulin in type 2 diabetes patients
  10. Vitamin K supplementation does not reduce diabetes
  11. A higher consumption of whole grains, fruits and dairy products reduces type 2 diabetes risk
  12. A diet of below 45 En% carbohydrate during 3 to 6 months reduces HbA1c level of patients with type 2 diabetes
  13. Vitamin C supplementation for at least 30 days reduces glucose concentrations in patients with type 2 diabetes
  14. Magnesium supplementation reduces risk of cardiovascular disease among type 2 diabetes
  15. Weekly one serving of apple and pear reduces type 2 diabetes mellitus risk
  16. Reduced serum levels of folate and vitamin B12 increase peripheral neuropathy risk among patients with type 2 diabetes
  17. Vitamin C and D reduce blood pressure in patients with type 2 diabetes

2016:

  1. A higher intake of plant protein decreases risk of type 2 diabetes among women

2015:

  1. Garlic supplementation during 12 weeks reduces fasting blood glucose

2014:

  1. Exercise lowers the risk for diabetes conferred by insulin resistance
  2. 1-6 cups/day caffeinated or decaffeinated coffee is associated with reduced type 2 diabetes risk
  3. Exercise training helps to prevent and to treat type 2 diabetes in youth
  4. At least 25g dietary fiber intake per day reduces risk of type 2 diabetes
  5. Niacin supplementation reduces LDL cholesterol levels in patients with type 2 diabetes mellitus

2012:

Diabetes increases risk of dementia and mild cognitive impairment

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The human body wants the blood glucose (blood sugar) level maintained in a very narrow range of 4 to 8 mmol/l. Insulin and glucagon are the hormones which make this happen. Both insulin and glucagon are secreted from the pancreas.

When the blood glucose level drops below 4 mmol/l (after physical exercise or on awakening) the alpha cells of the pancreas release glucagon. Glucagon converts glycogen into glucose. The glucose is released into the bloodstream, increasing blood sugar levels.
On the other hand, when the blood glucose level rises above 8 mmol/l, whether as a result of glycogen conversion or from digestion of a meal, insulin is released from beta cells of the pancreas. This hormone causes the liver to convert more glucose into glycogen and to force about 2/3 of body cells to take up glucose from the bloodstream through the GLUT4 transporter, thus decreasing blood sugar levels.

Diabetes mellitus describes a group of chronic metabolic diseases in which the person has a high blood glucose level, either because insulin production is inadequate or because the body's cells do not respond properly to insulin (also called insulin resistance) or both. Diabetes can be divided into two types: type 1 and type 2.

Type 1 diabetes:
The human body does not produce insulin. This type of diabetes is also called insulin-dependent diabetes, juvenile diabetes or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.

Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. Type 1 diabetes is not curable and is generally a form which is less common than type 2.

Type 2 diabetes:
In type 2 diabetes the body does not respond properly to insulin. Type 2 diabetes occurs mainly in the elderly and in people who are overweight (BMI>25). The treatment of type 2 diabetes is the first of dietary advice in conjunction with achieving a healthy weight (BMI = 18.5-25). Unlike type 1, type 2 is curable. Type 2 diabetes is also referred to as non-insulin-dependent diabetes mellitus.

Approximately 90% of all cases of diabetes worldwide are of this type.

These are the consequences that many diabetics may experience:

  • Amputation of limbs
  • Depression
  • Heart diseases
  • Skin problems
  • Gastrointestinal problems
  • Kidney disease
  • Eye problems
  • Problems of the joints
  • Problems with brains
  • Sexual problems
  • Foot problems
  • Nerves disorders

Dietary guidelines for diabetes prevention:

  • Choose products with minimum 1.5 grams of fiber per 100 kcal, products with maximum 30 En% fat, products with maximum 7 En% saturated fat, products with 10-20 En% protein, products with maximum 10 En% sugars and products with a low GI value (55 or lower) or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain minimum 1.5 grams of fiber per 100 kcal, maximum 30 En% fat, maximum 7 En% saturated fat, 10-20 En% protein and maximum 10 En% sugars.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical activities per day or at least 10000 steps per day.
  • Eat at least 3 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel. Oily fish contains more EPA and DHA than non-oily fish.
  • Eat 300 grams of vegetables and five servings of fruit a day or 30-40 grams of fiber per day.
    40 grams of fiber per dag corresponds to a daily diet of minimum 2 grams of fiber per 100 kcal.
  • Eat plenty of whole grains, such as brown bread and oatmeal and legumes.
  • Limit to 2-3 glasses of alcohol for men and 1-2 glasses for women a day or <30 g alcohol per day.

Vitamin D deficiency increases blindness in people with diabetes

Objectives:
Vitamin D levels have been shown to be associated with diabetic retinopathy, however to date, no review has examined the relationship between vitamin D and sight threatening diabetic retinopathy (STDR) and non-sight threatening diabetic retinopathy (NSTDR). Therefore, this review article has been conducted. 

Does vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL) increase risk of diabetic retinopathy in patients with diabetes?

Study design:
This review article included 11 cross-sectional studies and 1 case-control study with a total of  9,057 participants.
There was no publication bias.

Results and conclusions:
The investigators found vitamin D deficiency significantly increased risk of sight threatening diabetic retinopathy with 80% [OR = 1.80, 95% CI = 1.40 to 2.30, p ≤ 0.001, I2 = 39.39%].
However, this increased risk was not found for non-sight threatening diabetic retinopathy [OR = 1.10, 95% CI = 0.90 to 1.27, p = 0.48, I2 = 30.21%].

The investigators concluded that vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL)  increases risk of sight threatening diabetic retinopathy but not non-sight threatening diabetic retinopathy. Given the well-reported associations between vitamin D deficiency and other unfavourable outcomes, it is important that vitamin D deficiency is managed appropriately and in a timely manner to reduce the risk of blindness in people with diabetes.

Original title:
Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis by Trott M, Driscoll R, […], Pardhan S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167360/

Additional information of El Mondo:
Find more information/studies on vitamin D and diabetes right here.

Diabetic retinopathy, also known as diabetic eye disease (DED), is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

 

50 g/d almond decreases causally bad cholesterol in patients with type 2 diabetes

Objectives:
An enhanced risk for cardiovascular disease (CVD) still exists even when patients with type 2 diabetes have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, this review article has been conducted. 

Does almond consumption improve risk factors (cholesterol, triglycerides, fasting plasma glucose, insulin, hemoglobin A1c (HbA1c), body mass index, weight, body fat, systolic and diastolic blood pressure and CRP) of cardiovascular disease in patients with type 2 diabetes?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found there was a causal relationship between almond dietary intake and a  significant reduction in low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) [WMD = -5.28 mg/dL, 95% CI = -9.92 to -0.64, p = 0.026] in patients with type 2 diabetes compared with the control group.
This lowering effect of LDL cholesterol was robust in subgroups with almond consumption >50 g/day and baseline LDL cholesterol level 130 mg/dL.

The investigators found, however, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol), fasting plasma glucose, insulin, HbA1c, body mass index, weight, body fat, systolic and diastolic blood pressure and CRP was not significant compared with the control group.

The investigators concluded that a dietary intake of at least 50 g/d almond decreases causally LDL cholesterol (bad cholesterol) but has no favourable effect on other cardiometabolic outcomes in patients with type 2 diabetes. Further high-quality studies are needed to firmly establish the clinical efficacy of the almond.

Original title:
Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials by Moosavian SP, Rahimlou M, […], Jalili C.

Link:
https://pubmed.ncbi.nlm.nih.gov/35443097/

Additional information of El Mondo:
Find more information/studies on almond consumption and diabetes right here.
 

Ginger supplementation reduces blood pressure in patients with type 2 diabetes

Objectives:
There is some evidence regarding the positive effects of ginger supplementation on metabolic profile in patients with type 2 diabetes (T2DM). However, they are conflicting and therefore, this review article has been conducted. 

Does ginger supplementation improve metabolic profile (FBS, HbA1c, TC, TG, LDL, HDL, SBP and DBP) in patients with type 2 diabetes?

Study design:
This review article included 10 RCTs.

Results and conclusions:
The investigators found pooled meta-analysis showed a significant reduction in fasting blood sugar (FBS) level following ginger supplementation by polling 8 effect sizes [WMD = -18.81, 95% CI = -28.70 to -8.92, I2 = 77.4%].

The investigators found pooled meta-analysis showed a significant reduction in HbA1c level following ginger supplementation by polling 7 effect sizes [WMD = -0.57, 95% CI = -0.93 to -0.20, I2 = 88.6%].

The investigators found pooled meta-analysis showed a significant reduction in systolic blood pressure (SBP) following ginger supplementation by polling 5 effect sizes [WMD = -4.20, 95% CI = -7.64 to -0.77, I2 = 97%].

The investigators found pooled meta-analysis showed a significant reduction in diastolic blood pressure (DBP) following ginger supplementation by polling 5 effect sizes [WMD = -1.61, 95% CI = -3.04 to -0.18, I2 = 93.2%].

The investigators found pooled meta-analysis showed ginger supplementation had no significant influence on lipid profile involving triglyceride (TG), total cholesterol (TC), LDL cholesterol and HDL cholesterol.

The investigators concluded supplementation with ginger reduces fasting blood sugar, HbA1c, systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes. Further large RCTs are required to shed light on this issue.

Original title:
The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials by Ebrahimzadeh A, Ebrahimzadeh A, […], Milajerdi A.

Link:
https://pubmed.ncbi.nlm.nih.gov/35031435/

Additional information of El Mondo:
Find more information/studies on lowering blood pressure and diabetes right here.
 

Higher concentrations of carotenoids reduce type 2 diabetes

Objectives:
Previous meta-analysis studies have indicated inverse associations between some carotenoids and risks of metabolic syndrome, cardiovascular disease, cancer and all-cause mortality. However, the results for associations between carotenoids and type 2 diabetes (T2D) remain inconsistent and no systematic assessment has been done on this topic. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary intakes and circulating concentrations of carotenoids reduce risk of type 2 diabetes?

Study design:
This review article included 13 studies.

Results and conclusions:
The investigators found for the the highest versus the lowest categories of dietary intake of β-carotene a significantly reduced risk of 22% for type 2 diabetes [pooled RR = 0.78, 95% CI = 0.70 to 0.87, I2 = 13.7%, n = 6].
This significantly reduced risk was also found for total carotenoids (n = 2), α-carotene (n = 4), and lutein/zeaxanthin (n = 4), with pooled RRs ranging from 0.80 to 0.91, whereas no significant associations were observed for β-cryptoxanthin and lycopene.

The investigators found for the the highest versus the lowest categories of circulating concentration of β-carotene a significantly reduced risk of 40% for type 2 diabetes [pooled RR = 0.60, 95% CI = 0.46 to 0.78, I2 = 56.2%, n = 7].
This significantly reduced risk was also found for total carotenoids (n = 3), lycopene (n = 4), and lutein (n = 2), with pooled RRs ranging from 0.63 to 0.85, whereas no significant association was found for circulating concentrations of α-carotene and zeaxanthin when comparing extreme categories.

The investigators found dose-response analysis indicated that nonlinear relations were observed for circulating concentrations of α-carotene, β-carotene, lutein and total carotenoids [all p-nonlinearity 0.05], but not for other carotenoids or dietary exposures.

The investigators concluded that higher dietary intakes and circulating concentrations of total carotenoids, especially β-carotene, are associated with a lower risk of type 2 diabetes. More studies are needed to confirm the causality and explore the role of foods rich in carotenoids in prevention of type 2 diabetes.

Original title:
Dietary Intake and Circulating Concentrations of Carotenoids and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Observational Studies by Jiang YW, Sun ZH, [...], Pan A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33979433/

Additional information of El Mondo:
Find more information/studies on carotenoids and diabetes right here.

 

Chair-based exercise programmes improve upper extremity and lower extremity function in older adults

Objectives:
Do chair-based exercise programmes improve upper extremity and lower extremity function in older adults?

Study design:
This review article included 25 studies with a total of 1,388 participants.
19 studies were randomised controlled trials (RCTs).

The chair exercises included chair-based yoga, seated tai chi and rocking chair. The interventions lasted between 2 and 72 weeks, with the most common duration being 12 weeks, delivering 2 to 14 sessions per week. Sessions lasted between 15 and 110 minutes.

There was considerably heterogeneity in the age range of participants included.
The mean age of participants in studies ranges from 55 to 88 years.
17 studies had a low risk of bias and 5 had a high risk of bias.

Results and conclusions:
The investigators found that chair-based exercise programmes significantly improved upper extremity [handgrip strength: MD = 2.10, 95% CI = 0.76 to 3.43, I2 = 42% and 30 s arm curl test: MD = 2.82, 95% CI = 1.34 to 4.31, I2 = 71%] and lower extremity function [30 s chair stand: MD = 2.25, 95% CI = 0.64 to 3.86, I2 = 62%].

The investigators found no significant differences in the Berg balance scale, timed up and go test or gait speed between the intervention and control groups. Similarly, no significant differences were observed for self-reported activities of daily living or for falls efficacy, which were analyzed using standardised mean difference between the intervention and control groups as there were different instruments used to measure each outcome.

The investigators concluded that chair-based exercise programmes improve upper extremity (handgrip strength and 30 s arm curl test) and lower extremity (30 s chair stand) function in older adults. These changes are observed in short (12 weeks) and medium term (12 weeks to 6 months) interventions.

Original title:
The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis by Klempel N, Blackburn NE, […], Tully MA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920319/

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Upper extremity is part of the body that includes the arm, wrist and hand.
Lower extremity refers to the part of the body from the hip to the toes.

Dietary sodium restriction causally reduces blood pressure in patients with type 2 diabetes mellitus

Objectives:
Although current guidelines recommend reduction of salt intake in patients with diabetes, the benefits of reducing salt intake in people with type 2 diabetes mellitus (T2DM) lack clear evidence. Therefore, this review articles has been conducted.

Does dietary sodium restriction causally reduce blood pressure in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included 8 RCTs with 10 trials (7 cross-over and 3 parallel designs).
No publication bias was found from Begg's and Egger's tests.

Results and conclusions:
The investigators found compared with ordinary sodium intake, dietary sodium restriction significantly decreased 24-hour urine sodium level [WMD = -38.430 mmol/24h, 95% CI = -41.665 mmol/24h to -35.194 mmol/24h].

The investigators found dietary sodium restriction significantly lowered systolic blood pressure [WMD = -5.574 mm Hg, 95% CI = -8.314 to -2.834 mm Hg, I2 = 0.0%] and diastolic blood pressure [WMD = -1.675 mm Hg, 95% CI = -3.199 to -0.150 mm Hg, I2 = 0.0%].

The investigators concluded that dietary sodium restriction causally reduces systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes mellitus (T2DM).

Original title:
Effect of dietary sodium restriction on blood pressure in type 2 diabetes: A meta-analysis of randomized controlled trials by Ren Y, Liqiang Qin L, […], Ma Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/33838996/

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Salt consists of sodium and chloride. So a dietary sodium restriction means a reduction in dietary salt intake.

A diet with dietary salt restriction is a diet with maximum 0.2 grams of salt per 100 kcal.

The easiest way to follow this diet is to choose only products/meals with maximum 0.2 grams of salt per 100 kcal. These products from the supermarket contain maximum 0.2 grams of salt per 100 kcal.

However, the most practical way to follow this diet is, all your daily consumed products/meals should contain on average maximum 0.2 grams of salt per 100 kcal.
To do this, use the 7-points nutritional profile app to see if your daily diet contains maximum 0.2 grams of salt per 100 kcal.

Daily 80g potato increase type 2 diabetes among Western populations

Objectives:
Evidence regarding associations between potato consumption and type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) risks is accumulating. Therefore, this review article has been conducted.

Does a high potato intake increase type 2 diabetes and gestational diabetes mellitus (diabetes mellitus during pregnancy) risk?

Study design:
This review article included 19 studies (13 for type 2 diabetes and 6 for gestational diabetes mellitus) with a total of 21,357 type 2 diabetes cases among 323,475 participants and 1,516 gestational diabetes mellitus cases among 29,288 pregnancies.

Results and conclusions:
The investigators found meta-analysis showed a significantly increased risk of 19% [RR = 1.19, 95% CI = 1.06 to 1.34] for type 2 diabetes for total potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 8% [RR = 1.08, 95% CI = 1.00 to 1.16] for type 2 diabetes for baked/boiled/mashed potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 33% [RR = 1.33, 95% CI = 1.03 to 1.70] for type 2 diabetes for French fries/fried potato intakes among Western populations.

The investigators found dose-response meta-analysis demonstrated a significantly increased type 2 diabetes risk by 10% [95% CI = 1.07 to 1.14, p for trend 0.001], 2% [95% CI = 1.00 to 1.04, p for trend = 0.02] and 34% [95% CI = 1.24 to 1.46, p for trend 0.001] among Western populations for each 80 g/day (serving) increment in total potato, unfried potato and fried potato intakes, respectively.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 22% [95% CI = 1.06 to 1.42, p for trend 0.007] among Western populations for each 80 g/day (serving) increment in total potato intakes.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 26% [95% CI = 1.07 to 1.48, p for trend = 0.006] among Western populations for each 80 g/day (serving) increment in unfried potato intakes.

The investigators concluded that higher potato intake (at least 80g per day) is associated with higher type 2 diabetes risk among Western populations. The positive relationship presents a significant dose-response manner. Wisely controlled potato consumption may confer potential glucometabolic benefits.

Original title:
Dietary potato intake and risks of type 2 diabetes and gestational diabetes mellitus by Guo F, Zhang Q, [...], Ma L.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130021/

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Vitamin C supplements improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus

Objectives:
Does vitamin C supplementation improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus?

Study design:
This review article included 15 studies with 872 participants.

Results and conclusions:
The investigators found, findings from 15 studies indicated that vitamin C supplementation significantly decreased triglyceride (TG) levels [WMD= -16.48 mg/dL, 95% CI = -31.89 to -1.08, p 0.001] and total cholesterol (TC) levels [WMD = -13.00 mg/dL, 95% CI = -23.10 to -2.91, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found, however, vitamin C supplementation failed to improve LDL (bad cholesterol) and HDL cholesterol (good cholesterol) levels. 

The investigators found the meta-regression analysis suggested that lipid profile improvement was affected by duration of vitamin C treatment.

The investigators found dose-response analysis showed that vitamin C supplementation changed LDL cholesterol significantly based on vitamin C dose.

The investigators concluded that vitamin C supplementation improves lipid profile via decreases in triglyceride and total cholesterol levels in patients with type 2 diabetes mellitus. It appears that vitamin C supplementation is more beneficial to lipid profile in long-term vs. short term interventions.

Original title:
Does vitamin C supplementation exert profitable effects on serum lipid profile in patients with type 2 diabetes? A systematic review and dose-response meta-analysis by Namkhah Z, Ashtary-Larky D, […], Asbaghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33984490/

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Supplementation with L‐arginine alone increases VO2 max in healthy people

Objectives:
The efficacy and safety of L‐arginine supplements and their effect on maximal oxygen uptake (VO2 max) remained unclear. Therefore, this review article has been conducted.

Does supplementation with arginine increase VO2 max in healthy people?

Study design:
This review article included 11 RCTs.
The different types of arginine supplements were L‐arginine, arginine aspartate, arginine alpha‐ketoglutarate and arginine in combination with antioxidants.
There was no publication bias.

Results and conclusions:
The investigators found subgroup analysis showed that arginine in the form of L‐arginine significantly increased VO2 max compared to the other forms [weighted mean difference = 0.11 L/min, I2 = 0.0%, p = 0.485].

The investigators concluded that supplementation with L‐arginine alone increases VO2 max compared to the other types of arginine or combined with other metabolites or supplements. Future homogeneous and well‐designed randomized clinical trials are needed to a deep understand of the effects of L‐arginine on VO2 max in healthy human subjects.

Original title:
The effect of L-arginine supplementation on maximal oxygen uptake: A systematic review and meta-analysis by Rezaei S, Gholamalizadeh M, […], Doaei S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883807/

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VO2 max is the maximum amount of oxygen your body can utilize during exercise. The more oxygen your body can use, the more your muscles can work.

Prenatal alcohol exposure increases placental abruption

Objectives:
Does prenatal alcohol exposure have adverse effects on pregnancy and birth outcomes?

Study design:
This review article included 33 studies.
The quality assessment identified that 61% of studies were high quality, 30% were average quality and 9% were low quality.

Results and conclusions:
The investigators found that prenatal alcohol exposure significantly increased the likelihood of placental abruption with 48% [odds ratio = 1.48, 95% CI = 1.37 to 1.60].

The investigators found no association between prenatal alcohol exposure and placenta previa [odds ratio = 1.14, 95% CI = 0.84 to 1.34].

The investigators found that prenatal alcohol exposure significantly reduced placental weight with 51g [95% CI = -82.8g to -19.3g].

The investigators found reports of altered placental vasculature, placental DNA methylation, and gene expression following prenatal alcohol exposure.

The investigators concluded prenatal alcohol exposure increases the likelihood of placental abruption and is associated with decreased placental weight, altered placental vasculature, DNA methylation and molecular pathways. Given the critical role of the placenta in determining pregnancy outcomes, further studies investigating the molecular mechanisms underlying alcohol-induced placental dysfunction are required. Sex-specific placental adaptations to adverse conditions in utero have been well documented; thus, future studies should examine prenatal alcohol exposure-associated placental outcomes separately by sex.

Original title:
Prenatal alcohol consumption and placental outcomes: a systematic review and meta-analysis of clinical studies by Steane SE, Young SL, […], Moritz KM.

Link:
https://pubmed.ncbi.nlm.nih.gov/34181895/

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Spirulina supplementation reduces bad cholesterol among type 2 diabetes patients

Objectives:
Does spirulina supplementation improve glycemic related markers (like, fasting blood glucose, post prandial blood sugar and HbA1c levels) and lipid profile (like, triglyceride and cholesterol levels) among type 2 diabetes patients?

Study design:
This review article included 8 RCTs (9 arms).

Results and conclusions:
The investigators found, spirulina supplementation significantly reduced fasting blood glucose levels [-17.88 mg/dL, 95% CI = -26.99 to -8.78, I2 = 25%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced triglyceride levels [-30.99 mg/dL, 95% CI = -45.20 to -16.77, I2 = 50%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced total cholesterol levels [-18.47 mg/dL, 95% CI = -33.54 to -3.39, I2 = 73%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced LDL cholesterol (bad cholesterol) levels [-20.04 mg/dL, 95% CI = -34.06 to -6.02, I2 = 75%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced VLDL cholesterol levels [-6.96 mg/dL, 95% CI = -9.71 to -4.22, I2 = 33%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly increased HDL cholesterol (good cholesterol) levels among type 2 diabetes patients.

The investigators found no significant effect on HbA1C or post prandial blood sugar among type 2 diabetes patients following spirulina supplementation.

The investigators concluded that spirulina supplementation has beneficial effects on fasting blood glucose and blood lipid profiles among type 2 diabetes patients.

Original title:
The effect of spirulina on type 2 diabetes: a systematic review and meta-analysis by Hatami E, Ghalishourani SS, […], Mansour-Ghanaei F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34178867/

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Whey protein supplementation increases lean body mass in adults

Objectives:
Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of essential amino acids can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soya and whey protein supplementation on body composition. Therefore, this review article has been conducted.

Does whey protein or soya protein supplementation improve body composition parameters (like lean body mass, body mass, fat mass and body fat percentage) in adults?

Study design:
This review article included 10 RCTs with 596 participants.

Results and conclusions:
The investigators found a significant increase in lean body mass after whey protein supplementation [WMD = 0.91, 95% CI = 0.15 to 1.67, p = 0.019].
This significant increase was not found for soya protein supplementation.

The investigators found no significant change between whey protein supplementation and body mass, fat mass and body fat percentage.

The investigators found no significant change between soya protein supplementation and body mass, fat mass and body fat percentage.

The investigators concluded that whey protein supplementation improves body composition via increases in lean body mass, without influencing fat mass, body mass and body fat percentage in adults.

Original title:
Comparison of the effect of soya protein and whey protein on body composition: a meta-analysis of randomised clinical trials by Damaghi MP, Mirzababaei A, […], Mirzaei K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33971994/

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Grapes/grape products supplementation reduces HOMA-IR values in adults

Objectives:
Does grapes/grape products supplementation improve glycemic indices (like HOMA-IR, Hb1Ac and fasting insulin level) in adults or in other words, does eating grapes or grape products causally improve glycemic indices in adults?

Study design:
This review article included 29 RCTs with a total of 1,297 participants.

Results and conclusions:
The investigators found, overall, the grapes/grape products supplementation significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) [WMD = -0.54, 95% CI = -0.91 to -0.17, p = 0.004] in adults.   
Significantly because the calculated p-value of = 0.004 was less than the p-value of 0.05.

The investigators found, however, the grapes/grape products supplementation did not affect fasting insulin levels [WMD = -0.90 μIU/mL, 95% CI = -1.04 to 2.84, p = 0.362] and hemoglobin A1c (Hb1Ac) percentage [WMD = 0.00%, 95% CI = -0.10 to 0.11, p = 0.916] in the main analyses.
Did not affect because the calculated p-value of 0.916 was larger than the p-value of 0.05.

The investigators concluded that the grapes/grape products supplementation reduces homeostatic model assessment of insulin resistance (HOMA-IR) in adults. Further, large-scale RCTs with longer duration are required to confirm these results.

Original title:
The effect of grapes/grape products on glycemic response: A systematic review and meta-analysis of randomized controlled trials by Moodi V, Abedi S, […], Miraghajani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33893683/

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Homeostatic model assessment of insulin resistance (HOMA-IR) is a method for assessing β-cell function and insulin resistance (IR) from basal (fasting) glucose and insulin or C-peptide concentrations. HOMA-IR is an indicator of insulin resistance in diabetic patients. The higher the value, the more resistant you are to insulin. Diabetic patients often have a high HOMA-IR value.

Protein quality has significant impact on indices of muscle protein anabolism in young and older adults

Objectives:
There is much debate regarding the source/quality of dietary proteins in supporting indices of skeletal muscle anabolism. Therefore, this review article has been conducted.

What is the effect of protein source/quality on acute muscle protein synthesis (MPS) and changes in lean body mass (LBM) and strength, when combined with resistance exercise (RE)?  

Study design:
This review article included 27 studies that compared the effects of ≥2 dose-matched, predominantly isolated protein sources of varying "quality”, in young (18-35 y) and older (≥60 y) adults.

3 separate models were employed as follows: 1) protein feeding alone on muscle protein synthesis, 2) protein feeding combined with a bout of resistance exercise on muscle protein synthesis and 3) protein feeding combined with longer-term resistance exercise training (RET) on lean body mass and strength.  

The mean age for the young groups across all 3 models ranged between 20 and 29 y and the older groups were between 61 and 75 y.

Results and conclusions:
The investigators found analysis revealed an effect favoring higher-quality protein for postprandial muscle protein synthesis at rest [mean difference (MD) = 0.014%/h, 95% CI = 0.006 to 0.021, p 0.001] and following resistance exercise [MD = 0.022%/h, 95% CI = 0.014 to 0.030, p 0.00001] in young [model 1 = 0.016%/h, 95% CI = -0.004 to 0.036, p = 0.12. Model 2 = 0.030%/h, 95% CI = 0.015 to 0.045, p 0.0001] and older [model 1 = 0.012%/h, 95% CI = 0.006 to 0.018, p 0.001. Model 2 = 0.014%/h, 95% CI = 0.007 to 0.021, p 0.001] adults.  

The investigators found, however, although higher protein quality was significantly associated with superior strength gains with resistance exercise training [standardized mean difference (SMD) = 0.24 kg, 95% CI = 0.02 to 0.45, p = 0.03], no effect was observed on changes to lean body mass [SMD = 0.05 kg, 95% CI = -0.16 to 0.25, p = 0.65].

The investigators concluded that protein quality provides a small but significant impact on indices of muscle protein anabolism in young and older adults. However, further research is warranted to elucidate the importance of protein source/quality on musculoskeletal aging, particularly in situations of low protein intake.

Original title:
Protein Source and Quality for Skeletal Muscle Anabolism in Young and Older Adults: A Systematic Review and Meta-Analysis by Morgan PT, Harris DO, […], Breen L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245874/

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Chromium supplementation improves lipid profile in patients with type 2 diabetes mellitus

Objectives:
Does chromium supplementation improve lipid profile (serum levels of triglyceride and cholesterol) in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included  24 RCTs (with 28 effect sizes).

Results and conclusions:
The investigators found that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) in patients with type 2 diabetes mellitus [MD = -6.54 mg/dL, 95 % CI = -13.08 to -0.00, p = 0.050].
Significant means that there is an association with a 95% confidence.

The investigators found that chromium supplementation resulted in a significant decrease in serum levels of total cholesterol (TC) in patients with type 2 diabetes mellitus [WMD = -7.77 mg/dL, 95 % CI = -11.35 to -4.18, p 0.001].

The investigators found that chromium supplementation significantly increased high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol) in patients with type 2 diabetes mellitus [WMD = 2.23 mg/dL, 95 % CI = 0.07 to 4.40, p = 0.043] level.

The investigators found, however, chromium supplementation did not have significant effects on low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) in patients with type 2 diabetes mellitus [WMD = -8.54 mg/dL, 95 % CI = -19.58 to 2.49, p = 0.129] level.

The investigators concluded that chromium supplementation decreases serum levels of triglyceride (TG) and total cholesterol (TC) and increases HDL cholesterol (good cholesterol) levels in patients with type 2 diabetes mellitus. It should be noted that the lipid-lowering properties of chromium supplementation are small and may not reach clinical importance.

Original title:
Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials by Asbaghi O, Naeini F, […], Naeini AA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33813266/

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L-arginine supplements do not reduce diabetes in adults

Objectives:
Does L-arginine supplementation improve biomarkers (fasting blood sugar, insulin, HbA1c and HOMA-IR values) of glycemic control in adults?

Study design:
This review article included 12 randomised clinical trials (RCTs).

Results and conclusions:
The investigators found L-arginine supplementation had no significant effect on serum fasting blood sugar (FBS) [weighted mean difference (WMD) = -3.38 mg/dL, 95% CI = -6.79 to 0.04, p = 0.53], serum insulin [WMD = -0.12 Hedges' g, 95% CI = -0.33 to 0.09, p = 0.27], glycated haemoglobin A1c (HbA1c) [WMD = -0.04%, 95% CI = -0.25 to 0.17, p = 0.71] and homeostasis model assessment for insulin resistance (HOMA-IR) [WMD = -0.48, 95% CI = -1.15 to 0.19, p = 0.15].
No significant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present review article could not confirm this benefit in humans.

Original title:
Effects of L-arginine supplementation on biomarkers of glycemic control: a systematic review and meta-analysis of randomised clinical trials by Karimi E, Hatami E, […], Askari G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33426939/

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Arginine is classified as a semiessential or conditionally essential amino acid, depending on the developmental stage and health status of the individual, that helps the body build protein. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products.
 

Tart cherry supplementation improves recovery from strenuous exercise

Objectives:
Does tart cherry (TC) supplementation improve recovery following strenuous exercise?

Study design:
This review article included 14 studies.

Results and conclusions:
The investigators found tart cherry supplementation had a small significant beneficial effect in reducing muscle soreness [effect size (ES) = -0.44, 95% CI = -0.87 to -0.02].

The investigators found a moderate significant beneficial effect was observed for recovery of muscular strength [ES = -0.78, 95% CI = -1.11 to -0.46] for tart cherry supplementation.

The investigators found a moderate significant effect was observed for muscular power [ES = -0.53, 95% CI = -0.77 to -0.29] for tart cherry supplementation.
A further subgroup analysis on this variable indicated a large significant effect of tart cherry supplementation on recovery of jump height [ES = -0.82, 95% CI = -1.18 to -0.45] and a small significant effect of tart cherry supplementation on sprint time [ES = -0.32, 95% CI = -0.60 to -0.04]. 

The investigators found a small significant effect was observed for both C-reactive protein [ES = -0.46, 95% CI = -0.93 to -0.00] and Interleukin-6 [ES = -0.35, 95% CI = -0.68 to -0.02] for tart cherry supplementation.

The investigators found no significant effects were observed for creatine kinase and tumor necrosis factor alpha (TNF-α) for tart cherry supplementation. 

The investigators concluded that tart cherry supplementation improves aspects of recovery from strenuous exercise.

Original title:
Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis by Hill JA, Keane KM, […], Howatson G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33440334/

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1.5 g/day garlic supplementation reduces adiponectin level among participants ˂30 years

Objectives:
Does garlic supplementation reduce adiponectin and leptin serum levels?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found that garlic supplementation did not significantly affect adiponectin [Hedges's = 0.20, 95% CI = -0.06 to 0.47, p = 0.12] and leptin [Hedges's = 0.08, 95% CI = -0.26 to 0.41, p = 0.65] concentrations in comparison with placebo.

The investigators found, however, in the subgroup analysis, significantly increased serum adiponectin level was seen following garlic supplementation in trials with a mean age of participants ˂30 years [Hedges's = 0.44, 95% CI = 0.01 to 0.87, p = 0.04], the doses ˂1.5 g/day [Hedges's = 0.38, 95% CI = 0.02 to 0.71, p = 0.04] and trials with duration ≥8 weeks [Hedges's = 0.48, 95% CI = 0.08 to 0.89, p = 0.02].

The investigators concluded that ˂1.5 g/day garlic supplementation during ≥8 weeks reduces adiponectin level among participants ˂30 years.

Original title:
Systematic review and meta-analysis of randomized, controlled trials on the effects of garlic supplementation on serum adiponectin and leptin levels by Shekarchizadeh-Esfahani P, Hassani B, […], Soraya N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33792129/

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Adiponectin is a fat-derived hormone that appears to play a crucial role in protecting against insulin resistance/diabetes and atherosclerosis (atherosclerosis is the dominant cause of cardiovascular disease (CVD)). Decreased adiponectin levels are thought to play a central role in the development of obesity, cardiovascular disease and type 2 diabetes in humans.

Peanut butter consumption may reduce type 2 diabetes

Objectives:
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results. Therefore, this review article has been conducted.

Does nut consumption reduce risk of type 2 diabetes?

Study design:
This review article included 5 prospective cohort studies and 3 cross-sectional studies.
The certainty of the evidence using NutriGrade was very low for all the exposures.

Results and conclusions:
The investigators found meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and type 2 diabetes.
Nonsignificant means that there is no association with a 95% confidence.

The investigators found meta-analyses of prospective cohort studies showed that peanut butter consumption significantly reduced type 2 diabetes incidence with 13% [RR = 0.87, 95% CI = 0.77 to 0.98, I2 = 50.6%, p = 0.16], whereas no association was observed between peanuts or tree nuts and type 2 diabetes.

The investigators found there was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies.

The investigators concluded peanut butter consumption may reduce type 2 diabetes incidence. May reduce because the certainty of the evidence using NutriGrade was very low.

Original title:
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies by Becerra-Tomás N, Paz-Graniel I, […], Salas-Salvadó J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33471083/

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Peripheral neuropathy is associated with lowered plasma vitamin B12 levels

Objectives:
Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B-vitamins, and vitamin treatment has shown mixed results. Therefore, this review article has been conducted.

Does a low vitamin B level increase the risk of peripheral neuropathy?

Study design:
This review article included 46 observational studies and 7 interventional studies.

Results and conclusions:
The investigators found the presence of peripheral neuropathy was significantly associated with lowered B12 levels [1.51, 95% CI = 1.23 to 1.84, n = 34, I2 = 43.3%, p = 0.003].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated methylmalonic acid levels [2.53, 95% CI = 1.39 to 4.60, n = 9, I2 = 63.8%, p = 0.005].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated homocysteine levels [3.48, 95% CI = 2.01 to 6.04, n = 15, I2 = 70.6%, p 0.001].

The investigators found treatment with vitamin B1 was associated with a significant improvement in symptoms of peripheral neuropathy [5.34, 95% CI = 1.87 to 15.19, n = 3, I2 = 64.6%, p = 0.059].

The investigators found B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement [1.36, 95% CI = 0.66 to 2.79, n = 4, I2 = 28.9%].

The investigators found analysis of 7 trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins [2.58, 95% CI = 0.98 to 6.79, I2 = 80.0%, p 0.001].

The investigators concluded peripheral neuropathy is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine levels. Well-designed studies, especially in non-diabetes peripheral neuropathy, are needed.

Original title:
Association between neuropathy and B-vitamins: A systematic review and meta-analysis by Stein J, Geisel J and Obeid R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33619867/

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Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

Increased methylmalonic acid levels are a sensitive indicator of mild vitamin B12 deficiency.
 

3 times per week 30-60 min high-intensity interval training causally reduce visceral adipose tissue

Objectives:
Visceral adipose tissue (VAT) are deleterious fat deposits in the human body and can be effectively reduced by exercise intervention. Despite well-established exercise prescriptions are available, the effective dosage of exercise for reducing VAT requires verification. Therefore, this review article has been conducted.

What is the most effective exercise dosage (modality, intensity, duration and amount) for decreasing visceral adipose tissue (VAT)?

Study design:
This review article included 32 RCTs with a total of 1,900 participants.

Results and conclusions:
The investigators found that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks [SMD = -0.39, 95% CI = -0.60 to -0.18] and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks [SMD = -0.26, 95% CI = -0.38 to -0.13] were beneficial for reducing visceral adipose tissue.

The investigators found, by contrast, resistance exercise, aerobic exercise combined with resistance exercise and sprint interval training had no significant effects on reducing visceral adipose tissue.

The investigators found no difference in visceral adipose tissue reduction was observed between exercising more or less than 150 minutes per week.

The investigators found meta-regression revealed that the effect of visceral adipose tissue reduction was not significantly influenced by an increase in the duration of or amount of exercise in an exercise program.

The investigators concluded that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks causally reduce visceral adipose tissue.

Original title:
Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials by Chang YH, Yang HY and Shun SC.

Link:
https://pubmed.ncbi.nlm.nih.gov/33558643/

Additional information of El Mondo:
Find here more information/studies about fat and sport nutrition. 

A causal relationship can be found in RCTs.

High intensity interval trainings are:
-using a stationary bike, pedal as hard and fast as possible for 30 seconds.
-after jogging to warm up, sprint as fast as you can for 15 seconds.
-perform squat jumps as quickly as possible for 30 to 90 seconds.

 

Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults

Objectives:
Does a low-carbohydrate diet (LCD) causally increase adiponectin concentration in adults?

Study design:
This review article included 11 RCTs with 534 participants in low-carbohydrate diet group and 513 participants in control group (group without a low-carbohydrate diet).
Proportion of carbohydrate from calorie was from 4 to 34% (4-34 En%).
Time of the follow-up varied between studies and ranged from 6 to 152 weeks.
Meta-regression analysis revealed that age [β = 0.04, p = 0.15], baseline BMI [β= -0.15, p = 0.15], time of follow-up [β = 0.01, p = 0.17], energy percentage of carbohydrates [β = 0.004, p = 0.90], energy percentage of protein [β = -0.12, p = 0.08], energy percentage of fat [β = 0.20, p = 0.61] and baseline adiponectin [β = 0.001, p = 0.97] are not sources of heterogeneity

Results and conclusions:
The investigators found low-carbohydrate diet significantly increased adiponectin concentration [0.02 µg/mL, 95% CI = 0.01 to 0.03, p 0.001].

The investigators found dose-response analysis indicated a nonlinear association between the percentage of carbohydrate and change in adiponectin level from baseline [p = 0.04].

The investigators found in subgroup analysis based on the proportion of carbohydrate from calorie, there was a significant increase in adiponectin concentration in studies that prescribed 30% of calorie from carbohydrates [0.12 µg/mL, 95% CI = 0.07 to 0.18].
In contrast, diets which consisted ≥30% of carbohydrates had no significant effect on adiponectin [0.50 µg/mL, 95% CI = -0.46 to 1.48].

The investigators concluded that a diet with 30% of calorie from carbohydrates (diet with 30 En% carbohydrates) causally increases adiponectin concentration in adults.

Original title:
Effect of low-carbohydrate diet on adiponectin level in adults: a systematic review and dose-response meta-analysis of randomized controlled trials by Shemirani F, Golzarand M, […], Mahmoudi M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33455438/

Additional information of El Mondo:
Find more information/studies on carbohydrate consumption, diabetes and cardiovascular diseases right here.

The most easy way to follow a diet with maximum 30% of calorie from carbohydrates (diet with 30 En% carbohydrates) is to choose only meals/products with maximum 30 En% carbohydrates. Check here which products contain maximum 30 En% carbohydrates. However, the most practical way to follow a diet with maximum 30 En% carbohydrates is, all meals/products that you eat on a daily basis should on average contain maximum 30 En% carbohydrates.
30 En% carbohydrates means that the total amounts of carbohydrates make up for a 30% of the total kcal of the diet.

Adiponectin is a protein hormone produced and secreted exclusively by adipocytes (fat cells) that regulates the metabolism of lipids and glucose. Adiponectin influences the body's response to insulin. Adiponectin also has antiinflammatory effects on the cells lining the walls of blood vessels.
 

1.5 g/day EPA + DHA improve insulin sensitivity in children

Objectives:
Fish oil has been shown to reduce the risk of metabolic disorders. However, the effects of fish oil intervention on glucose metabolism and insulin sensitivity are still controversial, especially in children. Therefore, this review article has been conducted.

Do fish oil supplements (EPA + DHA) improve insulin sensitivity in children?

Study design:
This review article included 13 RCTs with 567 children in placebo group (group without fish oil supplements) and 565 in fish oil group (intervention group).

No heterogeneity was found for the pooled and subgroup analyses.

Results and conclusions:
The investigators found compared with the placebo group, fish oil intervention had beneficial effects on insulin sensitivity in the pooled analysis [WMD = -0.219, 95% CI = -0.392 to -0.046, p = 0.013].

These beneficial effects were also found in subgroup analyses, when the fish oil intervention period was short-term (≤6 months) low dose (eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) dose 1.5 g/day) and high ratio (eicosapentaenoic acid to docosahexaenoic acid ≥1).

The investigators concluded fish oil supplements, especially 1.5 g/day EPA + DHA during 6 months, improve insulin sensitivity in children.

Original title:
Effect of Fish Oil on Insulin Sensitivity in Children: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials by Hou M, Zhou W, [...], Lv H.

Link:
https://pubmed.ncbi.nlm.nih.gov/33388274/

Additional information of El Mondo:
Find more information/studies on EPA + DHA and diabetes right here.